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No 4 (2017)
- Year: 2017
- Articles: 12
- URL: https://journals.eco-vector.com/2226-6976/issue/view/6701
Articles
Clinical and epidemiological characteristics of influenza in 2015-2016 and 2016-2017
Abstract
Objective. To analyze the clinical and epidemiological characteristics of influenza during the 2015-2016 and 2016-2017 epidemic seasons. Materials and methods. Federal State Statistical Observation Forms № 1, 2, 5, and 6; information from the official website of the Research Institute of Influenza, Ministry of Health of Russia; and the materials of the Russian Federal Service for Supervision of Consumer Protection and Human Welfare were used. Results. In the last season, influenza vaccination coverage in the Russian Federation increased from 31 to 38%. Immunization coverage increased in all risk groups and decreased by 18% among pregnant women in 2016 compared to 2015. Influenza vaccination of children in the 7-17 age group increased by 18.8% in 2016 compared to 2015. The compared epidemic seasons varied in timing and duration. The 2015-2016 season lasted 5 weeks while the rise in the incidence of influenza in 2016-2017 started earlier and its duration was 11 weeks. In the 2016-2017 epidemic season, the influenza mortality rates were 94.5% lower than those in 2015-2016. Conclusion. The found differences are clearly determined by the level of immunization coverage in all areas of the country, by the characteristics of the properties of the circulating pathogen, and by improvements in the clinical and laboratory diagnosis of infection.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):4-13
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Significance of serum cytokine levels in detecting immune disorders in children with viral meningitis
Abstract
Objective. To establish the clinical significance of the indicators of the blood cytokine status in determining the degree of immune disorders and the course of viral meningitis (VM) and the prediction of its outcome in children. Subjects and methods. ELISA was used to estimate the serum levels of interleukins (IL-lß, IL-2, IL-4, IL-6, IL-8, IL-10), TNF-а, and interferons (INF-а and INF-y) in 450 children aged less than 14 years with VM of different etiologies (enterovirus, arbovirus, mumps, adenovirus, and herpes virus) and in 50 healthy children of the same age. Results. It is established that an imbalance of cytokine regulation in children with VM depends on the period, severity, and course of the disease, is characterized by the activation of pro- and anti-inflammatory cytokines (IL-1ß, IL-4, IL-6, IL-8, IL-10, TNF-а) and the suppression of IL-2, IFN-а, and IFN-y, and reflects the severity of immune disorders. Conclusion. The findings may be used to predict the course of the disease, to determine the degree of immune disorders, to diagnose secondary immunodeficiencies, and to use appropriate immunomodulatory therapy.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):14-20
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Current approaches to treating generalized cytomegalovirus infection in infants
Abstract
The paper deals with the topical childhood problem cytomegalovirus infection (CMVI) due to its widespread and increased incidence. Objective. To improve treatment for generalized infant CMVI with the concomitant use of ganciclovir and interferon-а-2b (IFN-а-2b, viferon®). Subjects and methods. The investigation enrolled 24 babies aged less than 2 months, who were diagnosed with generalized CMVI. Among them, there were 15 (62.5%) boys and 9 (37.5%) girls. There were 3 groups: 1) 13 babies treated with ganciclovir for 14-21 days and then with IFN-a-2b in combination with vitamins Cand E; 2) 5 infants who underwent only symptomatic treatment for CMVI: hepatoprotective agents, broad-spectrum antibiotics (ceftriaxone, ampicillins) in the age dosage range; 3) 6 patients who received only ganciclovir. The therapy was performed through serum viral load monitoring at 14 and 21 days after treatment initiation. When Group 1 patients showed a reduction in the clinical manifestations of CMVI and a decrease in the viral load to 1О4-1О3 copies/ml, they were switched to IFN-a-2b in combination with vitamins C and E (rectal suppositories 15О,ООО IU) at 14-21 days according to the original scheme. Results. In Group 1, the virus was eliminated from the blood of all the infants within 3-6 months. Recurrent CMVI was absent in the babies. The agents were well tolerated and caused no adverse reactions. At the same time, the viral load in Group 2 not only decreased, but increased by 10-102 copies/ml in 1 patient. In Group 3, there was no blood elimination of the virus or its conversion to an inactive state. Conclusion. The combined use of ganciclovir and IFN-a-2b (viferon®) contributes to the elimination of the virus from blood and cerebrospinal fluid and to the keeping of the virus in the passive state, which prevents the development of complications. The proposed treatment for CMVI can be successfully used in both the inpatient and outpatient settings.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):21-25
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Efficiency of metabolite therapy for neuro-vegetative disorders in children with acute respiratory infections
Abstract
Objective. To evaluate the efficacy, tolerability, and safety of using a combination metabolite drug containing L-glutamic acid, glycine and L-cystine in comparison with basic therapy in the correction of neurovegetative disorders in children with acute respiratory infections. Subjects and methods. The investigation enrolled 53 patients aged 12 to 18 years with acute respiratory infections who had clinical manifestations of neurovegetative disorders. The patients were randomized into 2 groups: a study group (n = 27) and a control group (n = 26). The study group received the metabolite drug as part of combination therapy; the control group had the basic therapy. The duration of treatment was 30 days. All the patients underwent comprehensive assessment of the neurovegetative status at admission and at 1-month follow-up. Results. There were no patients with obvious asthenia in the study group at the follow-up, while the proportion of such patients was 3.8% in the comparison group. After the end of treatment, 70% of the patients in the study group were diagnosed with a predominance of sympathetic tone of the autonomic nervous system; these were only 42.3% in the comparison group (p < 0.05). At the same time, there was no obvious abnormal sympathetic regulation when the drug was used (unlike the comparison group where this was noted in 34.6% of cases; p < 0.01), suggesting that the functioning processes of the neuroregulatory system were restored. After treatment completion, the children in the study group had diminished central nervous break-down, enhanced working efficiency, improved performance, and lower-level anxiety. No adverse events or abnormal hemogram readings were recorded after completing the therapy cycle. Conclusion. The investigation showed the efficacy and safety of using the metabolite drug containing L-glutamic acid, glycine, and L-cystine in children with neurovegetative disorders in the presence of acute respiratory infections. The therapy contributed to the reduced severity of post-infection asthenia.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):26-31
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The place of PCR in the laboratory diagnosis of viral infections in routine practice
Abstract
Laboratory diagnosis is relevant to patients with immunodeficiency. This condition occurs in patients with hemoblastosis in the presence of the underlying disease and because of chemotherapy. The latter can also affect the pathogenesis of viral infection. Objective. To provide a rationale to use a PCR assay in the routine diagnosis of parenteral viral hepatitis and herpesviruses. Material and methods. The laboratory markers of herpesviruses, hepatitis B virus (HBV) and hepatitis C virus (HCV) were determined in the clinical samples from 997 patients with different stages of hemoblastoses occurring with pneumonia and/or respiratory failure and liver dysfunction (until hepatitis developed). Results. HBV infection was associated with low (up to 10 3IU/ml) viremia, HCV infection was related to high (more than 105 IU/ml) one. PCR could reveal the occult forms viral hepatitis and the early stages of infection and suggest that there was virus-associated liver damage in cryptogenic hepatits. Herpesvirus DNA was significantly more often detected in bronchoalveolar lavage fluid rather than in blood. Respiratory lesion is frequently associated with herpesviruses. Conclusion. PCR is a convenient method to detect occult virus infections in patients with hemoblastoses. In cryptogenic hepatitis, examination of biopsy specimens of the liver could suggest its virus-associated lesion. The laboratory diagnosis of viral infections should be comprehensive.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):32-39
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Myocarditis in modern pediatric practice
Abstract
Myocarditis is one of the nosological entities that are difficult to diagnose in daily clinical practice, which can result in fatal outcomes if timely adequate therapeutic actions are not undertaken. Clinicians rarely diagnose this pathology, despite the fact that it is accompanied by myocardial inflammatory changes in 1 to 10% of cases of infectious diseases, according to investigators. The paper presents basic information on myocarditis in children: classification, risk factors, etiology, pathogenesis, clinical picture, diagnosis, therapy and an algorithm for the management of patients in accordance with the current guidelines and the results of the authors’ investigations. Attention is drawn to the polymorphism of symptoms and the nonspecificity of detectable changes. Emphasis is laid on the high significance of electrocardiographic (ECG), ultrasound, and laboratory techniques that are available in a pediatrician’s daily practice. Probable myocarditis can be diagnosed based on the increased laboratory markers of myocardial damage, such as troponin, creatine kinase MB, and a-hydroxybutyrate dehydrogenase, as well as impairments detected by echocardiography. Etiotropic, metabolic, and symptomatic therapies are prescribed to patients.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):40-49
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A case of generalized tuberculosis in a HIV-infected woman during pregnancy
Abstract
The paper describes a clin ical case of the unfavorable course of generalized tuberculosis (TB) during pregnancy, which resulted in a fatal outcome in the late postpartum period. The baby was diagnosed with congenital TB. HIV infection with severe immunosuppression was first identified simultaneously with TB in the pregnant woman. The paper gives the characteristics of diagnostic and treatment tactics of comorbidity (HIV and TB) with a discussion of difficulties in diagnosing co-infection during pregnancy, indications for abortion, the choice of a chemotherapy regimen for TB, the timing of antiretroviral therapy for acutely progressive TB, and the possibility of early diagnosis of congenital TB.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):50-57
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Local cytokine profile in adult patients with acute enteric infections and its correction with immunomodulatory therapy
Abstract
Objective. To assess the intestinal cytokine profile in patients with acute enteric infections (AEI) in the dynamics of the disease during standard pathogenetic therapy and treatment according to the regimen added by aminodihydrophthalazinedione sodium (ADPNa). Subjects and methods. The patients were divided into 2 groups of 30 people each according to a therapy regimen. Group 1 received standard pathogenetic therapy. In Group 2, the regimen was added by ADPNa. The coprofiltrates taken at 1-2 days of the disease and 5 days later were used to determine the level of cytokines (interferon-y (IFN-y), IL-4, IL-6, and IL-10). Results. In both groups, the levels of IL-6 and IFN-y substantially increased, but those of IL-4 and IL-10 kept normal in the height of the disease. In Group 2, the level of IL-6 significantly decreased and that of IL-10 increased at hospital discharge. Only the similar insignificant trend was observed in Group 1. Changes in the cytokine profile also affected the duration of the symptoms of the disease. In Groups 1 and 2, the duration of diarrhea was 5.5 ± 0.2 and 4.0 ± 0.2 days, respectively (p < 0.01). Conclusion. The findings make it possible to recommend that the local cytokine profile should be corrected with ADPNa in the combination treatment of AEI.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):58-64
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Sociomedical characteristics of persons in contact with hiv-infected patients
Abstract
Objective. To provide sociomedical characteristics of persons who are in contact with HIV-infected patients. Subjects and methods. This investigation was conducted in the Sverdlovsk Regional Center for AIDS Prevention and Control, by using the software module «Dispensary Follow-Up of the Contacted». Contact persons were divided into several dispensary follow-up groups. The findings were analyzed by sex, age, social status, education level, additional risks, and reasons for striking off the dispensary register. Results. The introduction of the software module «Dispensary Follow-up of the Contacted» could substantially improve work with this group of persons. Different gender and age and social characteristics were established to be characterized for different types of contacts. The main risk of infection is to preserve sexual intercourse with an HIV-infected (82.0% among heterosexual partners and 82.9% among homosexual ones). The frequency of transition from HIV-negative contacts to HIV-positive ones amounted to 1.8% of the total number of those registered. The highest detection rate of HIV infection is typical for groups of partners of people living with HIV/AIDS people using intravenous drugs. Conclusion. The medical care standard should be developed for the timely and full identification of people in contact with HIV-infected patients, their observation with examination, patronage and pre- and post-contact chemoprophylaxis.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):65-70
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Investigation of the efficacy and inhalation toxicity of an air disinfectant in the human breathing zone for the nonspecific prevention of airborne infections
Abstract
Objective - to determine the efficacy and inhalation toxicity of the chlorine dioxide (CD) generator Barrier Reef used as a personal air disinfectant to inactivate the pathogens of airborne infections. The investigations conducted at the Research Institute of Influenza, Ministry of Health of Russia (Saint Petersburg), showed that the CD generator had high virucidal activity against influenza virus; when CD was used at low, low-toxic concentrations, the virus titer in the air samples was reduced by 90% at 1-3 min, by 97% at 3-5 min, and by 99% at 10-12 min. The agent was effective at least 30 days. The inhalation toxicity of CD was investigated in the experiments using the rats that were kept in an atmosphere of CD for a certain time. Then the structure of the trachea and lungs was histologically determined; the degree of oxidative stress was estimated from the tissue level of malonic aldehyde and the changes in the gene expression of all classes of antioxidant enzymes (a total of 15 different enzymes). The structure of the tracheal and lung epithelium was ascertained to be completely preserved; in this case, there were no increases in apoptotic cell death in both tissues or in lipid peroxidation in lung tissue. The enhanced protection of tracheal and lung epithelial cells against the highly toxic reactive oxygen species generated in the tissues is associated with the activation of gene expression of antioxidant enzymes in the epithelium, which is observed within the f irst hours after action of CD. The results of the investigations allow the air disinfectant Barrier Reef to be recommended for the prevention of airborne infections.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):71-77
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Interdisciplinary panel discussion of leading experts of the Russian Federation on vaccination against human papillomavirus infection
Abstract
The 17th All-Russian Congress of Dermatovenerologists and Cosmetologists, within which there was an interdisciplinary panel discussion of leading experts of the Russian Federation on vaccination against human papillomavirus infection, was held in Moscow on 20-23 June 2017. The main points of the reports submitted to this panel discussion are outlined.
Epidemiology and Infectious Diseases. Current Items. 2017;(4):78-83
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In memory of Galina Vasilyevna Yushchenko
Epidemiology and Infectious Diseases. Current Items. 2017;(4):84-84
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